ASK THE EXPERTS

AVRAM GOLD, MD.

Avram R. Gold, MD, Medical Director of the Sleep Disorders Center, provides information about sleep disorders and how to get a better night's sleep.

How much sleep do we need? According to the American Sleep Association, the amount of sleep each person needs depends on many factors, including age. For most adults, 7 to 8 hours a night appears to be the best amount of sleep, although some may need as few as 5 hours or as many as 10 hours of sleep. It's important to pay attention to your own sleep needs by assessing how you feel after different amounts of sleep.

What is a sleep disorder? A sleep disorder refers to inadequate or poor quality sleep. Approximately 15 percent of the U.S. population has some kind of sleep disorder, which translates into a half million people on Long Island alone. The most common sleep disorder is insomnia, of which there are two kinds. Sleep onset insomnia is the inability to fall asleep, and sleep maintenance insomnia is the inability to stay asleep. If you find you have one of these issues and have not been helped by the typical recommendations for getting a good night's sleep, it may be time to see a sleep specialist. (See "Tips for Getting a Better Night's Sleep.") Stony Brook's state-of-the-art Sleep Disorders Center, the most experienced on Long Island, provides expert consultation, diagnosis, and treatment for sleep disorders in adults and children.

Tips for Getting a Better Night's Sleep

Keep your bedroom dark and quiet.

Try to go to sleep and get up at the same times every day, even on weekends.

Avoid caffeine four to six hours before bedtime.

Exercise regularly, but not less than two hours before bedtime.

Avoid naps.

Don't sleep with pets. Their movements may wake you, as well as trigger allergies that may worsen breathing.

Don't bring waking time activities, such as working on your laptop, into bed. Your bedroom should help trigger a mindset of relaxation.

How can a sleep specialist help? At Stony Brook's Sleep Center, patients can consult with our board-certified sleep specialists. If needed, patients may have a nocturnal polysomnogram, which monitors brain activity, breathing, oxygen saturation, movement, and electrocardiographic activity during an overnight stay. If we identify an organic underlying cause, we might be able to recommend several options, including a nasal continuous positive airway pressure (CPAP) mask, which provides an air pressure "splint" to the throat; an oral appliance similar to a mouthguard that modifies the position of the jaw to clear the airway; medication; or, in a few cases, surgery.

What distinguishes Stony Brook in the area of sleep disorders?We are a comprehensive sleep center-the first on Long Island to offer a full spectrum of diagnostic and treatment services. We continue to be a leader by bringing pioneering research to benefit patients. What's most exciting is the research being conducted here on upper airway resistance syndrome (UARS) that is changing how experts across the world are viewing sleep disorders. What we discovered for many people, particularly women who snore lightly, is that their throats collapse when they sleep. The brain interprets this as a threat, causing them to develop a fight or flight response. In these cases, hormones and adrenaline take over, often resulting in insomnia. We have also found that this response contributes to a number of other disorders, including fibromyalgia, irritable bowel syndrome, anxiety disorders, migraine headaches, and temporomandibular joint syndrome (TMJ). What's interesting is that, typically, sleep/breathing disorders such as apnea are thought to occur in people who are overweight and women who are post-menopausal. UARS primarily affects thin young women. Our studies show that treating the breathing problem through an intervention such as a nasal CPAP device results in a 35 to 50 percent improvement in symptoms in all of these conditions-without the use of medication. Dr. Mohammad Amin at the Sleep Center has applied these same research principles to treat veterans with Gulf War Syndrome, and found that using the nasal CPAP results in a 35 to 45 percent improvement in symptoms, again, without the use of medication.

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